Means for artificially reproducing the actions of the heart and blood circulation and the factors controlling the same



June 5, 1951 E. ROUCKA 2,556,043

MEANS FOR ARTIFICIALLY REPRODUCING THE ACTIONS OF THE HEART AND BLOOD CIRCULATION AND THE FACTORS CONTROLLING THE SAME Filed Sept. 30, 1948 Patentea June 5, 1951 MEANS FOR ARTIFICIALLY REPRODUCING THE ACTIONS OF THE HEART AND BLOOD CIRCULATION AND THE FACTORS CON- TROLLING THE SAME Erich Roucka, Brunn, Czechoslovakia Application September 30, 1948, Serial No. 52,114 In Czechoslovakia April 4, 1948 Claims. 1

The circulation of the blood in human beings and animals corresponds in hydro-mechanical respect to the flowing of a liquid in a very complicated circulatory system which is affected by various physiological and pathological factors. The complexity of the system makes it very diflicult exactly to follow the individual and manifold combined influences which have an effect on the flow; yet an accurate knowledge as to how they are associated with one another is of the greatest importance for the understanding of the numerous physiological and pathological phenomena. Many diseases make themselves evident directly or indirectly in the form of definite hydromechanical features of the circulation of the blood and the true appreciation of these features is a valuable auxiliary means for the diagnosis.

According to the present invention the problem of reproducing the natural circulation of the blood in hydro-mechanical respect is solved by the use of a flow of liquid in an artificial circulatory system, wherein for the imitation of the different components of the mechanism influencing the circulation of the blood and including the physiological and pathological factors adjustable mechanical devices are employed, the hydromechanical influences of which upon the flow of the artificial circulation are equivalent to the action of the components and factors to be reproduced upon the natural circulation of the blood. The artificial circulatory system is provided with devices for determining the hydromechanical values and enables the action of the different influences upon the flow tobe observed either separately or in various combinations. In this way a medical student is enabled to get conviently a clear idea, even in complicated cases, as regards the hydro-mechanical process by tests repeated as frequently as desired, while selectively altering the conditions, and in this way clearly grasp the relationship between them, of which he could not otherwise obtain a clear picture.

The essence of the invention is hereinafter described with reference to the accompanying drawing which illustrates diagrammatically and by way of example one mode of carrying the invention into effect.

The apparatus essentially consists of: four pulsation pumps A, B, C, D, arranged in series with one another, which pumps represent the heart; a device E inserted between the pumps B and C and representing the lung; a device F representing the elasticity of the arteries; a device G which imitates the peripheral circulation 2 of the blood; a device H corresponding to the blood collectors, which device is associated with regulating devices J, K; and pipes which connect the said devices together in a suitable manner.

The pump A, which corresponds to the righthand ante-chamber of the heart, is constituted by a container I closed at the top by a freely movable diaphragm 2 provided at its centre with a rigid fiat portion and a projection. The pipe 88 opening into this container and corresponding to the return of the blood through the veins is adapted to be closed by a flap valve 31 which opens in one direction only, the same representing valves of the veins. A lever 4 pivoted on a fixed axle is connected at its left-hand end by means of a rod I to the lever B carrying a roller which abuts against a cam 9 mounted on the shaft I I9, the right-hand end of the lever 4 being connected to a spring 5 which hangs on to an adjustable control lever 6.

The cam 9 is provided with a tooth-like recess and is driven from a motor (not shown) through the intermediary of a friction drive I20, 1I2I and I22 and through a shaft I I9.

A pipe I0 containing a flap valve II representing the trienspidalis leads from the pump A to the pump B; the deflection of the valve can be adjusted as desired by means of adjusting levers I2 and I3.

The pump B corresponds to the right-hand chamber of the heart. The same consists of a container I4 which is closed at the top by a freely movable diaphragm I5. A lever I6 supported at its right-hand end by the adjusting screw I9 is connected by means of a rod I! to the crank disc I8 which is driven synchronously with the cam 9. The spring 20, the tension of which can be regulated by means of an adjusting screw 2 I, tends to press the right-hand end of the lever I6 downwards. A manometer 22 is connected to the container I4. During its oscillating movement the lever I 6 presses the diaphragm l5 more or less downwards according as to how high the latter has been lifted up from the liquid contained in the container I4, thus pumping the corresponding amount of liqiud, depending upon the degree of filling, into the pipe 26.

The pipe 26 is provided with a non-return flap valve 23 co-operating with adjusting levers 24 and 25, which limit the deflection of the valve in both directions. The valve 23 represents the pulmonalis.

A pipe 33 leads to the device E which represents the lung. This device consists of a container 21 which is closed at the top by a loose diaphragm 28. The latter is connected to a lever 29 which is loaded by a spring El, the tension of which can be varied by means of an adjusting lever 32. The diaphragm 23 supports the valve member SIlwhich throttles more or less the outlet opening of a pipe 55 of the container 21. Thedeflections of the lever turning around its left-hand end can be read on a corresponding scale. A pipe 35 provided with a manometer 45 leads into the pump C representing the lelfthand ante-chamber of the heart. The construction of this pump is the same as that of the pump A. Like the latter it comprises a container 31, a diaphragm 38, a lever 39, a rod tz a lever 43 provided With a roller, a cam s t, a spring lil, an adjusting lever ll and a non-return flap valve 36.

The pump D representing the left-hand ch amber of the heart is connected to the pump C by means of a pipe t9. 7

The pipe 69 encloses anon-return flap. valve 46 with adjusting levers Ill and A8 for the limitation of the stroke; this valve represents the mitralis. V V

4 The construction of the pump D and its function are the same asthose described with reference to the pump B, It comprisesia container 50, a diaphragm 5i, a lever, 52, a rod 53, a crank disc 54,; adjusting screws 55, 57, a spring,56, a manometer59 and an outletpipe 58. Thelatter is provided with a non-return valve 6!} associated with means BI, 62 for limiting the stroke. This valve represents the valve, of the aorta.

A pipe'63 with a manometer E l proceeds from beyond the non-return valve Ell to. the device F which serves for thedemonstration of the varying elasticity of the arteries. The device F consistsof a container 65 closed by a resilient diaphragm66. A lever 6'1 is connected to the latter and its left-hand end is pulled upwards by a spring 68, The tension of the latter can be ad'- justed by'means of a screw 69. Thejlever 6i abuts against a roller Til which can be displaced in the longitudinal direction of the lever 67 by means of an adjusting screw lI.

A pipe l2 'proceeds from the device F to a .device for measuring the amount of thefiowing liquid or the speed of flow. Thismeasuring device consists of a piston which is displaceable in the longitudinal direction of a slotted cylinder and is provided with an index movable along a scale 14;

In a: further pipe I5 leading to the device G there is inserted a manometer l6 and a valve TI which can be adjusted with respect to a scale by meansof a lever 18. s

The device Gintended to represent the peripheral-circulation of the blood consists of a container 'I 9"provided with two openings closed by diaphragms all and 8E. The diaphragm 8| carries a valve 82 which throttles more or'less the opening or" a pipe Stand is connected with a lever 83 which is' pivoted around its left-hand end and is loaded by a weight M. Between the lever 83 and BEthere is inserted a displaceable roller 85. The container "i9 is provided with a manometer 87. The pipe 88, provided with a manometer 89, leads from the device G back to the pump A above described; whereby the main cycle is closed. 7

A rubber tube I 24 is connected to the pipe l2 by means of which tube the pulsating flow is ob served bythe sense of touch, in the same way as in the case of feeling the pulse.

A pipe I23 branches off the pipe I5 and is divided into two branches II! and IIB leading respectively to the devices J and K representing the regulators of the blood collectors.

The device K consists of a container I having two openings which are closed by diaphragms I0! and iil2. Each one of these carries a valve, whichvalvesare secured to a common balancing beam I05. A valve I03 throttles the opening of a pipe H8 and a valve It l throttles the opening of the pipe H6. When one of these valves is closed the other one opens. Two levers Iil'land 588 are. articulated to the left-hand end of the..balanoing beam m by means of a rod I06.

The lever ill? abuts against a displaceable roller l'iisa nd is connected by means of a rod I Ill to the leithand end ofa lever I II which pivots around itsf rig'ht-hand end and is loaded by a weight.

This lever is supported on the diaphragm H3 Which covers the container I I2, the pipe II'I branching off the pipe 523 opening therein. The right-hand end-of the lever I08 resting on the displaceable roller I25, is connected to the lever H5 bymeans of arod M4, the lever H5 being pivoted at its left-hand end and loaded with a Weight. LQA pipe IE3 leads from the device K to thepipe 381A A pipe 98 opens into the device K, which pipe is provided with amanometer 99 and pro ceeds from the device H representing the blood collector.

The device H consists of a container closed at the top by a diaphragm 9i and at the lower end by a diaphragm 92. A lever 93 is articulated to the diaphragm SI and is pivoted at its-left-hand end Its right-hand end is forked and is suspended by means of springs 95, 95 to the end of a displaceable adjusting rod 96. c The circulatory system hereinbefore described is completely filled with liquid and operates as follows; The speed of the cams 9 and M and of the crankdiscs I3 and 54, which are driven by the common shaft H9, is adjusted to the desired number of revolutions by means of the lever con trolling the friction gear I29, I2 I, which number vof revolutions can'be read on the-tachometer I25 calibrated to the number of pulses per minute. The liquid arriving in the pump A through the pipe .188 and the non-return valve 3 is driven by the oscillatory movement of the lever l and the movements of the diaphragm 2 into the pipe Ill whence it passes past the lifted up valve II into the pump B. It is necessary to point out that the diaphragm 2. is not capable of sucking liquid into the container I and that the liquid has to enter into the container I under a certain pressure. It then depends upon the amount that has penetrated into the container how high the diaphragm 2 is lifted and to what extent it is pressed down when the lever lmoves downwards. When the filling of the container I is small the amountfed by the pump is also small and vice versa. The downward pressing force of the lever G is dependent upon the tension of the spring 5, which can be-adjusted by means of the adjusting; lever 6. By reducing this tension the fatiguing of the heart muscle can be imitated, which is no longer sufiiciently strong for the normal reverse pumping of the blood from the right-hand antechamber A into the right-hand heart chamber 13.

The insuiiicient closing ability of the non-return j, valve I I representing the trienspidalis can be demonstrated by so adjusting the lever I3 that it prevents the complete closure of the valve. This means that at the systole of the chamber B there is a partial return flow through the valve II into the ante-chamber A. Also stenosis can be imitated, which owing to a degeneration of the valve renders the normal flow through the same impossible. For this purpose use is made .of the adjusting lever I2 which limits the opening,- of the valve II according to the adjustment.

Immediately after the liquid has been driven into the container I4, and the diaphragm I has been lifted up according to the amount of. liquid, the crank disc I8 begins to pull the lever I6 downwards, which sooner or later abuts] against the projection of the diaphragm I5 and begins to press the same downwards, thereby causing the liquid to be pressed out of the container I4 into the pipe 26. In order to be able to vary the time within which the lever I6 presses on the diaphragm I5 and thereby enable the changes in the elasticity of the heart muscle to be demonstrated as well as its ability to take up different amounts of blood and reverse the umping during the systole, the height of the right-hand end of the lever I 6 is adapted to be adjusted by means-of screws I9. It is clear that the amount of liquid that is fed is the smaller the higher the righthand end of the lever I6 is lifted up.

Any damage done to the heart muscle byinfection causing its pumping force to be reduced can be imitated by means of the adjusting screw 2I and spring 20, the tension of which determines the value of the pressing force of the lever I6 against the diaphragm I5. If the tension of the spring 20 is small the right-hand end of the lever I6 is more or less lifted up during the feeding stroke so that the diaphragm I5 is pressed downwards less than previously, with the result that the amount fed is reduced.

The non-return valve 23 in the pipe 26 represents the pulmonalis. The insufficient opening and closing of this valve can be demonstrated by means of the adjusting levers 24 and 25,: as

has been described above with respect to the valve II.

The device E representing the lung throttles the flow of the liquid by means of the valve 30 to the extent that the tension of the springil has been adjusted by means of the lever 32, which spring loads the lever 29 together with the diaphragm 28 and thereby also the valve 30. The throttling which thus occurs at the mouth of the pipe corresponds to the resistance of the flow through the lungs. By varying the tension of, the spring 3| different high pressures in the lung can be imitated.

The liquid then flows through the pipe 35 and through the valve 36 into the pump C corresponding to the left ante-chamber of theheart and whence it flows through the pipe 48; past the valve 46 representing the mitralis, into the pump D corresponding to the left heart chamber, leaving it through the pipe 58, past the non-return valve 60 representing the valve of the aorta.

All these devices work in a similar way and enable similar processes as those already described with reference to the devices A, II and B to be demonstrated.

The device F into which the liquid flows through the pipe 63 represents the effects of the varying elasticity of the arteries. As is known, the arteries of a child show a maximum and those of a sclerotic old person a minimum of elastic resiliency. This can be demonstrated by adjusting the roller 70 by means of the screw II and by varying the tension of the spring 68 by means of the screw 69. By displacing the roller 10 to the left and at the same time tensioning the spring 68 to such an extent that the medium pressure on the diaphragm 66 seems to be balanced, this diaphragm will be caused to effect, with given pressure variations, oscillations of maximum amplitude corresponding to the arteries of a child. On the other hand if the roller I0 is displaced as far as possible to the right and the tension of the spring 68 is reduced to such an extent that the minimum liquid pressure on the diaphragm 65 appears to be balanced, the diaphragm will effect, for the same pressure variations, minimum amplitudes of oscillations corresponding to the smaller elasticity of the arteries of old persons.

From the pipe I2 there is branched off behind the device F a tube I24, the elastic walls of which are tensioned strongly or weakly by the pulsating flow in the pipe I2, so that it is possible to follow the flow by the sense of touch in the same way as the pulse is felt in connection with the natural circulation of the blood.

The device I3 for measuring the speed of flow which is inserted in the pipe I2 behind the device F works as follows: Its piston, provided with an index and sliding in the cylinder provided with a longitudinal slot, is lifted at different heights according to the speed of flow and these heights are read on the scale 14. In this way we also obtain the volume of flow through the pipe I2 per minute.

An important device for demonstration purposes is G which represents the peripheral circulation of the blood. The throttle valve 11, adjustable by means of the lever I8, represents thetotal of the arteriols of the peripheral blood circulation which regulate the flow through the 1 capillaries and the pressure of the blood therein. The container I9 closed by the diaphragms and 8I imitates according to the position of the latter the variable volumes of the capillaries involved in the peripheral circulation. The valve 82 throttles the flow at the mouth of the pipe 88 and represents the total resistance of the capillaries through which the blood passes. The variable resistance and variable volume of the capillaries can be demonstrated by the displacement of the roller 85; the latter enables the position of the valve 82 to be adapted as desired for any position of the diaphragm 80 and therewith the different conditions in the peripheral circulation of the blood to be imitated.

The liquid passing through the valve 82 returns through the pipe 88 to the container I of the pump A which corresponds to the venous back flow of the blood in the right-hand antechamber of the heart.

In order to enable a circulation of different intensity to be maintained in the circulatory system a storage container is used, the actual liquid content of which does not take part in the circulation but can be momentarily introduced as desired into the circulatory system and is returned therefrom into the container. This storage container H corresponds to the blood collectors present in those devices in which no metabolism takes place that would require a blood circulation of substantial intensity. If the intensity of the circulation, that is to say the volume of the circulating liquid per minute, is to be increased, 'a definite amount of liquid must be transferred from the device H into the pump A.

This may be obtained by causing the rollers I09 In this way the valve I03 is opened and the valve 104 closed.- Lessli q-uid will then; flow through the pipesI n H6 into thedeviceK; past the. ,valve I04 than flows away past the valve 103 through the pipe, I I8 into the pipe 8 8. lnthis way a drop in pressure occurs in the container I so that liquid passes fromthe device H, the filling of which is loaded by the diaphragm 9|, lever 93, and springs 9 4, 95, into thepipe H8 and pipe 88 and therewith into the main cycle of the circulatory system. A similar effect may be obtained bydisplacement of the rod 96 in a downward direction, which causesa stronger loading ofthe diaphragm 9I by the springs 94 and 95. By proceeding in the opposite direction one can remove liquid from the circulatory system and effect a storage thereof in the device H, Wherefrom the liquid is expelled temporarily from the cycle 7 By means of the device J one can imitate the restrainers of the blood pressure which tend to maintain a desirable value of blood pressure in the organism by changing the vasomotoric tone through the nervous system. The pressure in the container H2 corresponding to the arteriolf pressure is:on1y partially balanced by the weight displaceable on the lever III so that the iever I 0 'I is subjected permanently to a, turning moment in a clockwise direction and the righthand end of the lever tends to press the rod, I06 1 on the lever I can be adjusted as desired by a displacement of the rollers I09, I25.

The adjustability of 7 all the mechanical devices hereinbefore referred to enables one faithfully to imitate in hydro-mechanical respect the influence of the most dilferent components of the organism as well as the physiological and pathological factors upon the blood circulation. a It isto be understood that the apparatus hereinbefore described is only given by Way of example. S0 far as only therepresentation; of a few fundamental processes of the natural blood circulation is concerned the apparatus can be simplified by dispensing with some of the described device s On the other hand, it is possible to increase the range of possible demonstrations by the insertion of further devices which copy in hydro-mechanical respect, certain components of the organism or 'difierent effects,

l la .7 .7 I I 1. In an apparatus for artificially imitating the actions of the, heart and of the blood circulation, incombination, acirculatory pipe; a circulating liquid; a pulsating pump fed exclusively bysaid-circulatory pipe and having a variable rate of delivery; and adjustable resistance to. cir-. culation arranged in said circulatory pipe in series to said pump; a container for a liquid; branchplpes, connected to said circulatory pipe before and behind saidresistance, respectively, and leading tosaid container; control means in said branchpip'es; and means for adjusting said control means so as to enable the liquid to flow from said circulatory pipe into said container and vice versa according to the position of said control means under the action of saidadj'usting means whereby the amount "or liquid fiOWiIIgItO said pump and the rate of delivery "of said pumpz ried of the heart and of blood circulation, com"- prising in combination, a circulatory system;- a circulating liquid; a pumping system for the imitations of the actions of the heart including four pulsating pumps connected in series with one another in said circulatory system, the first and third pulsating pump representing the righthand and left-hand ante chambers of the heart respectively, the second and fourth pulsating pump representing the right-hand and left-hand chambers of the heart respectively; each pump including a container having a freely movable wall adapted to assume a position dependent on the amount of liquid present in said container; a pulsating driving member acting on said movable wall during the downward stroke only, and adapted to press downward said movable wall for a distance variably depending on the position of said movable wall, and consequently on the amount of liquid present in said container; adjusting means for said pulsating driving member for imitating various heart conditions; four adjustable spring means, each urging one of said pulsating driving members downwards; means for separately adjusting the tension of each of said spring means for representing changes of the heart muscle; a housing; I a shaft rotatably supported in said housing; drives means rotating said shaft; variable transmission rneans operatively connecting said drive means to said shaft; a first cam means rigidly secured to said shaft and operatively connected to the driving member driving said first pulsating pump so as to impart short upwardly directed impulsesto it; a second cam means rigidly secured to said shaft and operatively connected to the driving member driving said third pulsating pump so as to impart short upwardly directed impulses to it; a first crank means rigidly secured to said shaft and operatively connected to the driving member driving said second pulsating pump so as to impart working strokes of longer duration to it; a second crank means rigidly secured to said shaft and operatively connected to said fourth pulsating pump so as to impart working strokes of longer duration to it; and non-return flap valves inserted between each two of said pumps, each of said flap valves corresponding to a heart valve. 7

3. Apparatus as claimed in claim 2, in which said adjusting means of said driving members of said movable walls include means for adjusting the length of the effective stroke of said pump for the purpose of representing the changes of the volume of the systole.

4. Apparatus as claimed in claim 2, including means for adjusting the stroke of said non-return flap valves for the purpose of representing an insufiicient closure and a stenose of the'valves of the heart.

5. Apparatus as'claimed in claim ZQindluding a device representing the haemo-dynamic operationof the lung, said device being inserted in said Circulatory system between said second and said third pump and including a container having a movable wall, a valve supported on said wall, a loading member for driving said valve into 'throt tling position, said device being adapted to act in opposition to the fluid pressure in said container, and means for'adjus'ting the said'loading member 'for the purpose of representing those influences which alter the blood pressure in the lung.

6. Apparatus as claimed in claim 2, including a device representing the variable elasticity of the arteries, said device being inserted in said circu- 9 latory system and including a container having a movable wall and adjusting means for varying the elastic resiliency of said wall with respect to the pressure variations in said container.

7 Apparatus as claimed claim 1, including a measuring device for measuring the rate of the flowing liquid.

8. Apparatus as claimed in claim 1, including a measuring device for measuring the pressure of the flowing liquid.

9. Apparatus as claimed in claim 1, and a measuring device including a tube having elastically resilient wall connected on to said circulatory system for ascertaining the changes in the conditions or flow by the sense of touch.

10. Apparatus as claimed in claim 1, including a device representing the peripheral circulation of the blood in the circulatory system, said device including an elongated container disposed in said circulatory pipe and having two movable Walls; a throttling valve controlled by one of said tWo movable Walls and disposed in the portion of said circulatory pipe connecting said elongated container with said pulsating pump for controlling the flow of said circulatory liquid in said circulatory pipe; manually operated means for adjusting the position of said throttling valve independently of the position of said movable Wall controlling the action of said valve, said manually operated means being arranged to act also on the other of said movable Walls.

11. Apparatus as claimed in claim 19, said means for moving said valve including a first lever articulated to said valve and having a fixed pivot, a second lever having a fixed pivot, a loading member on said second lever, and an adjustable loading member between said two levers.

12. Apparatus as claimed in claim 1, comprising a device representing the variable elasticity of the arteries, said device being disposed in said circulatory system and including a container having a movable Wall and adjusting means for varying the elastic resiliency of said Wall with respect to' the pressure variations in said container; said adjusting means including a lever articulated to said movable Wall, a supporting member for said lever, a spring loading said lever, means for adjusting the position of said supporting member with respect to said lever, and means for varying the tension of said spring; and an adjustable throttle member inserted in said circulatory system in front of said container.

13. In an apparatus for artificially imitating the actions of the heart and of the blood circulation, in combination, a circulatory pipe; a circulating liquid; a pulsating pump fed exclusively by said circulatory pipe and having a variable rate of delivery; an adjustable resistance to circulation arranged in said circulatory pipe in series to said pump; a storage container for the reception of a variable content of liquid expelled from said circulatory system and its reintroduction therein according to requirements; a pipe for transfering said liquid from said storage container to said circulatory system and 'vice versa; and means for controlling the transfer, the storage container having a movable wall, and a loading member on said Wall.

14. In an apparatus for artificially imitating iii the actions of the heart and of the blood circulation, in combination, a circulatory pipe; a circulating liquid; a pulsating pump fed exclusively by said circulatory pipe and having a variable rate of delivery; an adjustable resistance to ci culation arranged in said circulatory pipe in series to said pump; a storage container for the reception of a variable content of liquid expelled from said circulatory system and its reintroduction therein according to requirements; a pipe for transferring the liquid from said storage container to said circulatory system and vice versa; means for controlling the transfer, the storage container having a first movable wall, a loading member on said first movable wall, a second movable wall, and an adjusting member for said sec- 0ndv movable Wall.

15. In an apparatus for artificially imitating the actions of the heart and of the blood circulation, in combination, a circulatory pipe; a circulating liquid; a pulsating pump fed exclusively by said circulatory pipe and having a variable rate of delivery; an adjustable resistance to circulation. arranged in said. circulatory pipe in series to said pump; storage container for the reception of variable content of liquid expelled from said circulatory system and. its reintroduction therein according to requirements; a pipe for transferring the liquid from said storage container to said circulatory system and vice versa; means for controlling th transfer; the storage container having a movable Wall, and a loading member on said Wall; a regulating member arranged in said pipe and including a container, two valves, one of said valves being adapted to control the flow of fluid from said storage container into said circulatory system, and the other of said valves being adapted to control. the flow from said circulatory system into said storage container; a balancing beam being connected at its opposite ends to said two valves; a device for the representation of the blood restrainers, said device including a container having a freely movable Wall and connected to a branch of said circulatory system; a device representing the peripheral blood cycle arranged behind said device for the representation. of the action. of the blood restrainers; means for transferring the liquid pressure in said container to said balancing beam of said regulating member; means adapted to adjust the ratio of the transfer; means for loading said balancing beam by a counter-force tending to turn said beam in op posite direction; and means for adjusting effect of the counter-iorce on said beam.

' ERICH ROUCKA.

REFERENCES CITED The following references are of record in the file of this patent: 

